The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

Evaluation of the Effectiveness of an Asthma Educational Camp Implemented by Respiratory Care Students USING NIH/NHLBI GUIDELINES



Tom Blackson, BS, RRT1, 3, Joseph A. Ciarlo, BA, RRT1, 3, Robert Lang, BS, RRT1, 3, Tim Cox, BS, RRT2, John Rendle, AS, RRT2, Respiratory Care Students 1999-20033, Albert Rizzo, MD1. 1Christiana Care Health System, 2duPont Hospital for Children, 3Delaware Technical and Community College, Wilmington Campus, DE. 


Background:
The prevalence of asthma is increasing worldwide, particularly in children. It is the most common chronic disease of childhood and collectively accounts for over 100 million days of restricted activity and close to 500 thousand hospitalizations annually. The National Heart, Lung, and Blood Institute (NHLBI) has identified patient education concerning asthma self-management as a primary strategy to help overcome the devastating impact of this disease.

Purpose: To evaluate the educational impact of a one-week asthma day camp designed for moderate to severe asthmatic children.

Materials/Methods: Ninety children, 7 - 12 years of age with moderate to severe asthma as diagnosed by their physician using NHLBI guidelines, participated in "Spacer Camp" conducted in cooperation with the American Lung Association of DE, from 1999 through 2003. The camp design included conventional athletic and social activities, in conjunction with discrete periods of asthma education ranging from 1-1.5 hours per day. Each camp was conducted over the course of a five-day period during daytime hours. The educational objectives of the camp were based upon NHLBI Global Initiative Guidelines for Asthma. Each camper's knowledge of asthma pathophysiology, triggers, and medication therapy was evaluated before camp (BC), on day one, prior to the start of the education curriculum and again post camp (PC), on day five, following the completion of the camp's teaching component. A questionnaire was used to assess campers' knowledge using pre-printed questions and criteria for determining acceptable responses. A performance checklist was utilized for evaluation of each camper's psychomotor skills related to their MDI/spacer technique (MDI-S) as well as their peak expiratory flow measurement (PEFR) and reporting abilities. Pre and post camp performance was evaluated consistent with the time course previously described for knowledge assessment. The behavioral objective of the camp was to allow each camper to participate in camp athletic and social activities without an acute asthma exacerbation significant enough to warrant the camper's removal from activities. Respiratory Care Students (RCS) provided the educational instruction under the guidance of program faculty. The educational interventions included brief lectures, discussions, demonstrations, and focused games to reinforce the daily educational objectives. All outcome assessments were performed by the same credentialed respiratory care practitioners both BC and PC. 

Results: Asthma knowledge base and psychomotor skills performance demonstrated significant improvement PC when compared to BC, (p< 0.05). None of the ninety campers required removal from camp activities for reasons beyond previously prescribed medication therapy. 

  Pathophysiology Knowledge Triggers Knowledge Medications Knowledge MDI-S Performance PEFR Performance
Pre Camp  18%  53%  51%  72%  77%
Post Camp 89%* 92%* 78%* 94%* 95%*


* p<0.05

Conclusions:
An asthma camp designed upon NHLBI guidelines can be an effective asthma education strategy for young children diagnosed with moderate to severe asthma. RCS may implement an effective educational curriculum under the guidance of credentialed respiratory care practitioners. Camp style athletic and social activities can be conducted safely in moderate to severe asthmatic children using NHLBI guidelines for management and prevention of asthma exacerbation. Future investigation will evaluate the long-term impact of camp education on asthma self-management and behavior modification. 

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